TUESDAY, Feb. 26 (HealthDay News) -- Lack of sleep can lead you to eat larger portions of high-calorie foods and increase your long-term risk of weight gain, according to a small new study.
Swedish researchers asked 16 normal-weight males to choose their ideal portions of high-calorie meals and snacks. They did this when they had a normal night of about eight hours sleep and again when they went a night without sleep.
The participants chose larger portion sizes after the night with no sleep. They did this both before and after a breakfast, which suggests that sleep deprivation increases food intake regardless of whether a person feels full, said study author Pleunie Hogenkamp, of Uppsala University.
"Bearing in mind that insufficient sleep is a growing problem in modern society, our results may explain why poor sleep habits can affect people's risk to gain weight in the long run," Hogenkamp said in a university news release.
The study was published online Feb. 18 in the journal Psychoneuroendocrinology.
In a previous study, the same team of researchers found that young, normal-weight men who went a single night without sleep had increased activation of a brain region involved in the desire to eat.
Although the study found an association between lack of sleep and increased appetite for high-calorie foods, it did not prove a cause-and-effect relationship.

TUESDAY, Feb. 26 (HealthDay News) -- Obesity increases a person's risk for a certain type of colorectal cancer, while exercise lowers the risk, according to a new study.
Researchers analyzed data from women in the U.S. Nurses' Health Study and men in the Health Professionals Study to determine if there was a link between weight, exercise and the risk for CTNNB1-positive or CTNNB1-negative colorectal cancer.
CTNNB1 is a molecule implicated in cancer and obesity.
A higher body-mass index, or BMI (a measurement of body fat based on height and weight), was associated with an increased risk of CTNNB1-negative colorectal cancer, while physical activity was associated with a lower risk.
BMI and physical activity had no effect on the risk for CTNNB1-positive colorectal cancer, according to the study appearing Feb. 26 in the journal Cancer Research.
"Our results provide additional evidence for a causal role of obesity and a physically inactive lifestyle in a specific molecular subtype of colorectal cancer," Dr. Shuji Ogino, an associate professor of pathology at Dana-Farber Cancer Institute and an associate professor in the department of epidemiology at Harvard School of Public Health, said in a journal news release.
"If physicians are able to identify individuals who are prone to develop CTNNB1-negative cancer, then it would be possible to strongly recommend physical activity," Ogino added.
The findings also suggest that CTNNB1 could be a potential target for drugs to prevent and treat colorectal cancer in certain patients, Ogino said.

By Kathryn Doyle
NEW YORK (Reuters Health) - For heavy drinkers in treatment for domestic violence problems, an extra therapy session targeting alcohol abuse may help to speed overall improvement in violent behavior, according to a new study.
Alcohol can lower inhibitions and impair judgment, according to lead author Gregory Stuart of the University of Tennessee in Knoxville. "One theory is that alcohol can narrow focus to negative aspects of the environment, and is linked to impulsivity," he told Reuters Health.
Men who are arrested for domestic violence are usually referred by the court to group educational sessions called batterer programs, which don't always address alcohol - even though drinking is involved in a high percentage of domestic disputes, experts said.
Because previous research has found these programs especially ineffective for batterers who also have drinking problems, Stuart's team set out to test whether adding a therapy session devoted to alcohol would affect both drinking and violent behaviors over the course of a year.
For the trial, the researchers recruited 252 men who had been arrested in Rhode Island for violence against an intimate partner and who reported binge drinking (having five or more drinks per occasion) at least once a month.
All attended the court-mandated standard battery program, consisting of 40 hours of group educational programs split into 20 sessions, and half of the men attended an additional 90-minute one-on-one substance abuse session with a therapist.
The men were then asked to complete a survey about their behavior at 3, 6 and 12 months following the treatment program. The researchers also gathered any police reports relevant to the study participants, and analyzed only data for men who had intimate partners at the beginning of the study period.
On average, all of the men participating in the study reported lowered overall violence levels after one year, Stuart's team reports in the journal Addiction.
But participants who received the extra alcohol counseling session had greater short-term improvement in both violence and alcohol consumption compared to men in the standard batterer program.
When the researchers looked at specific aspects of partner violence, for example, men who received the alcohol intervention were less physically aggressive toward their partners at the three-month mark, and less psychologically aggressive at the six-month mark.
The alcohol-intervention group also drank less per day at the three-month mark and drank less often at the six-month mark.
But at every checkpoint in the study, there was little difference in overall frequency of partner violence in both groups, and after a year, the levels of physical and psychological aggression among men in the comparison group caught up to those of the men in the alcohol therapy group.
"I would have preferred to see these results maintained over time, but for the first six months the rate of improvement was greater for the folks who got the alcohol intervention," Stuart said.
The improvements associated with the extra alcohol-focused session didn't fade over time, Stuart pointed out, but the extra therapy seemed to give those men a "jump start" over the other group during the early months.
"These 90-minute motivational enhancements have been shown to be effective with a variety of different (people)," but usually for those who seek out treatment of their own accord, according to Kenneth Leonard, director of the Research Institute on Addictions at the University at Buffalo in New York who was not involved in the study.
For that reason, seeing any positive result, even a small one, in a group of men in a court-ordered program who had not sought treatment on their own was promising, Leonard said.
In Rhode Island, the 40-hour standard batterer program includes a short section on alcohol, but the duration and content of such programs can vary widely by state, according to Stuart.
Other studies have questioned the effectiveness of existing batterer programs, which Stuart says were "created with the best of intentions" but sometimes include methods that aren't supported by evidence and have a lot of room for improvement.
"All of the participants on average had substantially less substance use and violence relative to where they started, however, there was still too much violence and substance use," Stuart said.
He and his colleagues suggest that the jump-start might have lasted longer if there had been multiple follow up "booster" sessions with a therapist over the course of the year.
"When you start getting into these more severe samples, my sense is that something more than 90 minutes would be required, or additional sessions," Leonard agreed.
Although the gains were small and temporary, Stuart thinks the results of this study are a promising start toward improving batterer programs.
"The goal is to gently lead them to the conclusion that potentially stopping the use of alcohol and drugs is a good idea," he said.SOURCE: http://bit.ly/WaWGhk Addiction, online February 18, 2013.

TUESDAY, Feb. 26 (HealthDay News) -- When looking for ways to get a heavy child moving, soccer could prove a winner.
California researchers found that a soccer program increased the physical activity levels of overweight and obese children.
Researchers examined the impact that a community-based, after-school soccer and youth-development program called America SCORES had on the physical activity, weight and fitness of students in a large, urban school district.
The study, published online Feb. 25 in the journal JAMA Pediatrics, involved 156 students from six schools. The SCORES program was implemented at three of the schools.
The research team found that the program significantly increased moderate-to-vigorous physical activity among overweight and obese students after school (by 3.4 minutes per day) and on Saturdays (by 18.5 minutes).
The program did not, however, lead to significant changes in physical activity, fitness or weight among all the students in the study, said Dr. Kristine Madsen, of the University of California, Berkeley, and her colleagues.
"Existing community-based programs such as SCORES can increase physical activity among low-income youth, particularly those most at risk for weight-related [health issues]," the researchers concluded.

TUESDAY, Feb. 26 (HealthDay News) -- Millions of American women know the pain and emotional tumult of premenstrual syndrome, or PMS. But a new study finds that diets full of iron from plant-based sources might help ease the condition.
Women who ate in this way were about one-third less likely to develop PMS than women who consumed less iron, the researchers found. Non-meat sources of iron include dried beans and green leafy vegetables.
Another mineral makes a difference, the study found. Higher levels of zinc were also associated with less PMS over the 10-year study period. Zinc occurs in many fresh fruits and vegetables.
"It does look like a range of minerals are important for menstrual cycle health and for PMS. Women should consume a balanced diet, and if they're not getting enough nutrients from their diet, they should take a multivitamin," recommended senior study author Elizabeth Bertone-Johnson, an associate professor at the University of Massachusetts Amherst.
Bertone-Johnson said the researchers don't know exactly why iron might be associated with less PMS, because iron is involved in many processes in the body. They think higher levels of iron might reduce the pain and emotional symptoms of PMS by boosting levels of a brain chemical called serotonin. Low serotonin levels play a role in clinical depression, and Bertone-Johnson said that serotonin has been linked to PMS symptoms in other research.
As with iron, Bertone-Johnson said it wasn't clear how higher levels of zinc might protect against PMS.
Results of the study were published online Feb. 26 in the American Journal of Epidemiology.
PMS affects between 8 percent and 15 percent of women in their reproductive years, according to study background information. Symptoms can be physical or emotional, and may include breast tenderness, abdominal bloating, appetite changes, depression and anxiety.
The current research followed about 3,000 women enrolled in the U.S. Nurses' Health Study II. None of the women reported having PMS at the start of the study.
Over 10 years, the women completed three food-intake questionnaires. At the end of the study, 1,057 women reported PMS, and the remaining 1,968 women did not.
After adjusting the data for calcium intake and other factors, the researchers found that the women who consumed the most non-heme iron had up to a 40 percent lower PMS risk compared to the women who consumed the least non-heme iron. Non-heme iron is iron that comes from plant-based sources or supplements, rather than from meat.
The risk of developing PMS dropped significantly for women who consumed more than 20 milligrams (mg) of iron daily. The lowest risk was seen in women consuming nearly 50 mg of iron daily. However, the recommended daily intake for premenopausal women is 18 mg per day, according to Bertone-Johnson.
As for zinc, a slightly protective effect for women consuming more than 10 mg daily was also seen.
But, Bertone-Johnson cautioned, both of these minerals can be harmful if taken at above average levels.
The researchers found that higher potassium levels were linked to higher levels of PMS, although Bertone-Johnson said these and other findings from this research need to be confirmed in other studies. Interestingly, the researchers didn't find a connection between sodium, which can make you retain water, and PMS.
"PMS is probably multifactorial, and it's probably way more complicated than one or two supplements or mineral deficiencies might cause," said Dr. Fredric Moon, medical director of general obstetrics and gynecology at Winthrop University Hospital in Mineola, N.Y.
Moon advised women to check with their doctors before starting any type of supplements. Iron levels can be checked with a simple blood test, he said.
Clinical nutritionist Samantha Heller, at the NYU Center for Musculoskeletal Care, agreed. "It's important to speak with your physician before supplementing with any minerals," she said. "Too much iron can cause serious problems, and supplementing with something like zinc can knock your copper balance off. There's a delicate balance in the body, and women need to be very thoughtful before they start using supplements."
Heller explained that it's difficult to tease out the effect of any one particular nutrient. But, she added, "If a woman wants to shift to a more plant-based diet, it may contribute overall to reduced oxidative stress and inflammation, which may help reduce the symptoms of PMS, and heart disease and other conditions."
While the study found an association between dietary iron and zinc and decreased PMS symptoms, it did not prove a cause-and-effect relationship.

TUESDAY, Feb. 26 (HealthDay News) -- One in six people worries that they're sick even though their symptoms don't signal disease, and often these patients aren't swayed by tests that show they're fine, Scottish researchers report.
These patients continue to worry about being ill, and ask for more tests or that the same tests be done again, the researchers said.
"I was surprised that a lot of primary care doctors tend to order tests, even if there is not a substantial basis for them, in the hopes they would reassure patients and lessen their worry," said Dr. Bryan Bruno, acting chair of psychiatry at Lenox Hill Hospital in New York City.
Many patients suffer from hypochondria, which is the belief that physical symptoms are signs of a serious illness even when there's no medical evidence to support that belief, explained Bruno, who was not involved with the study.
"There are a lot of patients with hypochondriac tendencies and they tend to worry a lot, and negative test results often don't resolve their worry or show any kind of improvement in their symptoms of hypochondria," Bruno added.
The new report was published in the Feb. 25 online edition of JAMA Internal Medicine.
For the study, Dr. Alexandra Rolfe, from the University of Edinburgh, and Dr. Christopher Burton, from the University of Aberdeen, collected data from 14 studies that included nearly 4,000 patients.
Rolfe and Burton found that diagnostic tests had no effect on patients' concern about being sick or their anxiety. In 10 of the studies, patients continued to have symptoms of their imaginary disease, the investigators found.
"Diagnostic tests for symptoms with a low risk of serious illness do little to reassure patients, decrease their anxiety or resolve their symptoms, although the tests may reduce further primary care visits," the researchers concluded.
The consequences of this problem are unnecessary tests that add to the cost of medical care, and of doctors refusing to give new tests, which may force patients to seek medical help elsewhere, one expert said.
"There are no guarantees related to our health, and there is virtually no absolute certainty in medicine," said Dr. David Katz, director of the Yale University Prevention Research Center.
"We -- doctors and patients alike -- are obligated to deal with probabilities," he said. "When the probability of disease is very low before testing, a negative test cannot make it much lower."
There is an opportunity to educate the public in how probability influences medical decisions, Katz said. "This is information doctors and patients can and should share, to reach robust and reassuring conclusions together," he said.
"Doctors, however, should indulge patients only in testing that is of real potential value," Katz added.
Bruno added that doctors need to use their judgment when ordering tests and base them on the need for the test and whether the test is cost-effective.
There is more pressure now on doctors to justify their care, Bruno said.
"Doctors are really having to demonstrate they are delivering appropriate care, prescribing the right treatments and ordering the right tests," he said.
There are some patients who are delusional about their health, and these patients should seek mental health treatment, Bruno added.

TUESDAY, Feb. 26 (HealthDay News) -- Universal screening of newborns improves the detection of a deadly genetic disorder in both girls and boys, according to a new study.
The findings challenge the current belief about the detection of the severe salt-wasting form of congenital adrenal hyperplasia (CAH). It has commonly been thought that boys are at greater risk for delayed diagnosis, the researchers explained in the Feb. 25 online edition of The Lancet Diabetes and Endocrinology.
CAH is the most common adrenal disorder in children and affects the production of the hormone cortisol in the adrenal glands. The salt-wasting form of the disorder affects one in 10,000 to 15,000 newborns and can lead to neurological damage or intellectual disability, and death if not diagnosed and treated early enough.
Salt-wasting CAH is associated with overproduction of androgen hormones. This can result in girls being born with abnormal genitals while boys generally appear normal, the study authors noted.
Most developed countries routinely screen newborns for congenital adrenal hyperplasia, but that is not the case in all countries, including Australia and the United Kingdom.
"Until now it was believed that newborn boys with the severe salt-wasting form of CAH were at much greater risk of delayed diagnosis and early death than girls, as girls are more often diagnosed shortly after birth because of ambiguous genitalia, whereas boys appear normal. However, our data show that both boys and girls are missed by physical examination -- even in a country such as Sweden with a developed health care system -- and that newborn screening improves survival in both sexes equally," senior researcher on the study, Anna Nordenstrom, of the Karolinska University Hospital Huddinge in Sweden, said in a journal news release.
For their study, the researchers analyzed all known cases of congenital adrenal hyperplasia in Sweden between 1910 and 2011. There was a significant increase in diagnosed cases in the 1960s and 1970s, following the discovery of the first effective treatment in 1950 and increased awareness of CAH and its symptoms. The number of diagnosed cases increased again after the introduction of newborn screening in 1986.
The author of an accompanying journal editorial, Bridget Wilcken, of the Children's Hospital at Westmead and University of Sydney in Australia, wrote that "there is little doubt that screening for the disorder fulfills the essential criteria for screening -- it is, after all, a potentially lethal disorder -- and a 2010 study in the U.K. concluded that a case can be made for screening. Certainly, pediatric endocrinologists from Australia agree."

(HealthDay News) -- You want your kids to eat something healthy after school, but there's no time to cook something nutritious.
The Academy of Nutrition and Dietetics suggests these no-cook healthy snacks:

Make a frozen treat by dipping a peeled banana in yogurt, rolling it in crushed cereal and then freezing.

Shake up a fruit smoothie by combining a half cup each of low-fat yogurt and chilled 100 percent fruit juice in a container with a lid, and then shake.

Use fun-shaped cookie cutters (like dinosaurs, stars or hearts) to cut out sandwiches made with lean meat, low-fat cheese and whole-grain bread.

In a bowl, mix peanut butter with cornflakes or bran flakes, and then roll into balls. Roll the balls in crushed graham crackers to make tasty peanut butter balls.

(HealthDay News) -- When you're starting an exercise program, it's important to work out at the right intensity to make sure you're challenging yourself without pushing your body too hard.
The American Heart Association lists these tips to help you judge whether you are exercising at an appropriate intensity:

At a light intensity level, you should be able to comfortably sing while exercising.

You should be able to comfortably carry on a conversation while working out at a moderate intensity level.

You are exercising too vigorously if you are so winded that you can't carry on a conversation while you work out.

By Kerry Grens
New York (Reuters Health) - Patients with facial paralysis saw greater improvements in function after a more intensive form of acupuncture in a new study from China that compared the treatment to standard acupuncture.
Researchers found that wiggling the acupuncture needles to produce a sensation called "de qi" led to a patient's having a better chance of recovering full facial function in six months than if the needles were just inserted and left alone.
De qi "should be considered to be included in clinical guidelines for acupuncture treatment," said Dr. Wei Wang at Key Laboratory of Neurological Diseases of Chinese Ministry of Education in Wuhan, Hubei.
The study did not measure how well people would have recovered without receiving acupuncture, so it's impossible to say whether the therapy worked any better than conventional, Western approaches or no therapy at all.
De qi is combination of feelings - including achiness, coolness, warmth, and tingling - which is considered by traditional Chinese medicine to ensure the best therapeutic benefit, said Wang, one of the authors of the study.
But "this long held belief has never been confirmed," he told Reuters Health.
To see whether de qi makes a difference to the effectiveness of acupuncture therapy, he and his colleagues asked 317 adults with Bell's palsy to undergo five half-hour acupuncture treatments for four weeks.
Bell's is usually a temporary facial paralysis that typically affects one side and lasts a few months.
It often results from a viral infection that inflames facial nerves, and the steroid prednisone is a common treatment. Over the counter analgesics, vitamins and physical therapy are also sometimes used to treat the condition.
About 40,000 Americans get Bell's palsy each year, according to the National Institute of Neurological Disorders and Stroke.
Wang said his group focused on this condition because recovery of the facial nerves affected by Bell's does not seem to be as susceptible to the placebo effect as other nerve conditions, such as pain.
Half of the participants were randomly assigned to receive treatments that would elicit de qi, in which the acupuncturist twisted the needles and moved them up and down several times during the session.
The other participants had the needles inserted and left alone.
All of the patients also received prednisone.
Neurologists, who didn't know which treatment each participant had received, determined the patients' facial function score on a scale of 200, with higher numbers corresponding to better movement.
In both groups, patients had started with facial function scores around 130 to 135. After six months of treatment, participants in the de qi group had somewhat greater facial function, such as in raising the eyebrows, blinking and baring teeth.
The de qi group scored an average of 195, while the other acupuncture group scored 186.
Wang said it's difficult to interpret just what these numbers mean in terms of muscle performance - say, whether a person can smile fully or not - but that a difference of nine points would be noticeable to the patients.
In addition, the team found that 94 percent of participants who received de qi acupuncture completely recovered their facial function by the end of six months, while 77 percent did in the other acupuncture group.
It's not clear how acupuncture - and de qi in particular - might improve the recovery from Bell's palsy.
Dr. Jian Kong, an assistant professor at Harvard Medical School and Massachusetts General Hospital, said one explanation could be that needles in the face increase blood flow to the area "so we can provide more nutrition to the nerves and help the inflammation to diminish quickly so people can recover."
Kong, who was not part of this study, agreed with the researchers that de qi is important to consider in acupuncture research, and that it is often overlooked.
One reason it's not always included in studies is that "there are many schools of acupuncture," with some placing greater emphasis on de qi than others, Kong told Reuters Health.
De qi is also complex, subjective and difficult to quantify. He said some people even consider the sensations of the acupuncturist to be more important in eliciting de qi than the sensations of the patient.
"Most clinical trials don't measure de qi sensation so we don't know how this sensation is associated with clinical outcomes," Kong said.
Wang said that this lack of standardization in acupuncture research might be why studies have yielded a mixed bag of results - sometimes showing a benefit and other times not.
"The effect of acupuncture may be seriously compromised" by not stimulating de qi, he said.
Kong said he and others have been developing standard de qi scales to offer some uniformity across studies.
"Hopefully we can figure out how this sensation is connected with the clinical outcome," Kong said.SOURCE: http://bit.ly/XekkvV Canadian Medical Association Journal, online February 25, 2013.

By Andrew M. Seaman
NEW YORK (Reuters Health) - About one in six sudden infant deaths may be linked to their mothers' heavy alcohol use during or soon after pregnancy, according to a new study from Australia.
Researchers found those deaths may result from babies being exposed to alcohol in the womb and from alcohol-using mothers creating hazardous environments for the babies after birth.
"One of the morals of the story is that parents should be very careful about drinking alcohol, especially if you're a single parent because there is no other parent to back you up," said David Phillips, a professor at the University of California, San Diego, who has studied alcohol-related infant deaths but wasn't involved in the new research.
The U.S. Centers for Disease Control and Prevention (CDC) defines sudden infant death syndrome (SIDS) - also known as sudden unexpected infant death - as the death of a child under one year old with no obvious cause.
Approximately 4,500 infant deaths fall into this category every year in the U.S., according to the CDC.
Previously, researchers have tied SIDS to parents' smoking and to unsafe environments, but few studies have looked at whether alcohol could be involved in some of the deaths.
For the new study, the researchers, led by Colleen O'Leary from Curtin University in Perth, examined information on 77,895 women who gave birth between 1983 and 2005.
They compared the number of SIDS and infant deaths that occurred in children of mothers with a diagnosed drinking problem, to cases among the children of mothers without a diagnosis.
Overall, 171 SIDS cases occurred during that time in children born to the 21,841 women who were diagnosed heavy drinkers. Among the children who were born to 56,054 mothers without a diagnosis, there were 132 SIDS cases.
The researchers found that babies born to mothers who drank heavily during pregnancy had a seven-fold increase in the risk of SIDS, compared to children of mothers without a drinking problem.
Babies also had a nine-fold increased risk of SIDS when their mothers drank within the year after birth, compared to babies born to mothers who didn't drink.
O'Leary, who could not be reached for comment, and her colleagues also report that heavy drinking during pregnancy was tied to a doubled risk of infants dying from a cause unrelated to SIDS, compared to babies of mothers who were not heavy drinkers.
"The results of this study indicate that maternal alcohol-use disorder increases the risk of SIDS and (infant deaths) through direct effects on the fetus and indirectly through environmental risk factors," the team wrote in the journal Pediatrics on Monday.
The authors add that previous research suggests babies exposed to alcohol in the womb may have abnormalities in the brainstem, which could lead to problems regulating basic body functions like breathing.
But Phillips pointed out that the study found a link between infant deaths and a mothers' drinking as long as one year after giving birth.
"So it can't just be a biological explanation of what's going on," he said.
The mothers may be creating unsafe environments for their children, Phillips said. For example, a drunken parent may fall asleep with their baby in bed, and accidentally roll over and suffocate the child.
O'Leary's team writes that it found a number of causes for the children's deaths, including problems related to alcohol exposure in the womb and environmental factors - such as smoke inhalation, dehydration, infections and neglect.
The researchers suggest that preventing heavy drinking in mothers may bring the number of SIDS cases and infant deaths down.
A separate study, also published Monday in Pediatrics, found that doctors can use visualization and mapping software to identify babies who have slight facial deformities that may signal mental impairments from their mothers' drinking.
Phillips said it's also important for parents to understand that it only takes a couple drinks for their judgment to become impaired, and parents who plan to have a drink should have a sober "designated parent" to care for their child.
"A child is a vulnerable creature and we really owe it to protect that child. It's not a trivial thing to be a parent," he said.SOURCE: http://bit.ly/ZG8azK and http://bit.ly/YVVP5W Pediatrics, online February 25, 2013.

TUESDAY, Feb. 26 (HealthDay News) -- Ultrasound scans for patients with small abdominal aortic aneurysms may not be required as often as is currently assumed, a new study suggests.
An abdominal aortic aneurysm is an abnormal bulge in the section of the aorta -- the main artery that carries blood from the heart to the rest of the body -- that runs through the abdomen.
"The risk of rupture of abdominal aortic aneurysms increases as the diameter of the aneurysm increases," said one expert not connected to the study, Dr. Mark Adelman.
"If aneurysm ruptures, there is an 80 percent chance that the patient will not survive," said Adelman, who is a vascular surgeon at NYU Langone Medical Center and associate professor at the NYU School of Medicine in New York City. "It is imperative to identify these aneurysms and repair them before they are at high risk for rupture."
Typically, surgery is performed to reduce the risk of rupture in people with large abdominal aortic aneurysms. But researchers who reviewed 18 previous studies involving a total of nearly 15,500 patients concluded that for people with small aortic abdominal aneurysms (less than 2.2 inches in diameter), the risks of surgery are greater than the risk of rupture.
Monitoring with ultrasound scans is recommended for these patients. The researchers, led by Simon Thompson, of the University of Cambridge in England, also noted that most small abdominal aortic aneurysms grow slowly and that surveillance intervals of several years may be acceptable for the majority of patients with smaller aneurysms.
"Current recommendations for surveillance intervals vary widely, although the intervals usually decrease with increasing [aneurysm] diameter," Thompson wrote in the research.
The team said their review findings indicate that for men, gaps between ultrasound scans could range from one to three years, depending on the size of the aneurysm, and, in this scenario, "the risk of rupture would be maintained at less than 1 percent."
This means for a patient with an abdominal aortic aneurysm of just over 1 inch in diameter, "this would reduce the average number of surveillance scans from approximately 15 to seven," the British team said.
They said more research is needed to assess the frequency of monitoring for women with slightly larger aneurysms (just under 2 inches in diameter).
The study "clearly identifies that small aneurysms grow slower than larger aneurysms," Adelman said. "Therefore, the interval between scans should be longer in patients with smaller aneurysms."
"The standard of care in the United States is to image small aneurysms infrequently -- approximately every other year," he said. "Once the aneurysm grows to approximately [1.7 inches], annual ultrasound imaging is typically performed."
Therefore, "the findings in this study confirm the typical practice patterns in the United States, and incur costs of about $200 per year in patients with moderate- to large-sized aneurysms -- a cost effective strategy," Adelman said.
The study appears in the Feb. 27 issue of the Journal of the American Medical Association.

TUESDAY, Feb. 26 (HealthDay News) -- A drug often used to treat chronic heart failure may not ease symptoms in people with one form of the disease, a new study suggests.
The medication, called spironolactone (Aldactone), failed to improve symptoms or quality of life among 422 patients with diastolic heart failure -- a form of the disease that affects about half of all people with heart failure.
The drug did, however, benefit the structure and function of patients' hearts. And experts said it's too early to know what to make of the results, which appear in the Feb. 27 issue of the Journal of the American Medical Association.
"It would be premature to say this is not beneficial," said Dr. Sanjiv Shah, a cardiologist at Northwestern University Feinberg School of Medicine, in Chicago, who was not involved in the study.
Shah is involved in an ongoing study of spironolactone's effects in people with diastolic heart failure. And that trial is focusing on the big questions: Can the drug prevent or delay hospitalizations, or prolong people's lives?
Spironolactone is in a class of drugs called aldosterone receptor antagonists. They cause the kidneys to eliminate excess water and sodium from the body, so they can lower blood pressure and get rid of fluid build-up in some people with heart failure.
And studies have shown that spironolactone can extend the lives of some heart failure patients -- namely, those with a low "ejection fraction." That means the percentage of blood pushed out by the heart with each contraction is abnormally low.
The problem is that heart failure is "heterogeneous," according to Shah, who described it as a "syndrome" -- or a collection of signs and symptoms -- rather than a disease. So a treatment that works for some patients may not work as well for others.
In general, heart failure is a chronic condition where the heart does not pump blood efficiently enough to meet the body's needs. That causes symptoms such as fatigue, breathlessness and fluid build-up in the legs and feet.
In systolic heart failure, the heart's left ventricle (the main pumping chamber) cannot contract strongly enough, and many people with this form of heart failure have a reduced ejection fraction.
In the diastolic form, the left ventricle doesn't relax enough between contractions, which means it cannot fill up with as much blood as it should. But the heart's ejection fraction is actually normal.
Diastolic heart failure is trickier to diagnose, and doctors know less about how to best treat it, said Dr. John Cleland, a cardiologist at Hull York Medical School in Kingston-upon-Hull, England, who co-wrote an editorial published with the study.
He agreed that it's too soon to draw conclusions from the current findings, and that doctors will know more when Shah's study results are in.
"I think the public should wait for TOPCAT," Cleland said, referring to the acronym Shah's trial goes by.
For the current study, researchers led by Dr. Burkert Pieske, of the Medical University Graz, in Austria, recruited 422 patients diagnosed with diastolic heart failure. They randomly assigned half to add spironolactone to their current treatment, while the rest received inactive placebo pills.
Over one year, the drug did lower patients' blood pressure and improve their heart function. Based on echocardiograms, there was less thickening and resistance in the left ventricle.
But the patients did not report any improvements in their symptoms or quality of life. Nor did they perform any better on a treadmill walking test.
Cleland said it's not surprising that the patients would not be feeling better despite the objective improvement in heart function. That's been seen with other drugs, he noted.
Pieske said that the reasons are not fully clear. It's possible that the drug dose was not high enough, he said. Or the changes in heart function that his team saw may just not translate into benefits such as better walking ability.
On top of that, the patients in this study were actually fairly healthy, Shah and Cleland pointed out. So they may not have been sick enough to expect symptoms or walking ability to get noticeably better.
Shah and Cleland both suspect that many study patients may have had diastolic "dysfunction" in their hearts -- but were not sick enough to really have diastolic heart failure.
"I think that may underlie the findings (on symptoms)," Shah said.
For now, Pieske said doctors could still consider spironolactone for diastolic heart failure patients who need better blood pressure control.
The usual treatments for the condition include lowering blood pressure with drugs such as diuretics and ACE inhibitors, and slowing patients' heart rate with beta-blockers or other medications.
"Most people with diastolic heart failure are hypertensive, and getting blood pressure under good control is very important," Cleland said.
All agreed that better treatments are needed. "There is a real need to find therapies that improve outcomes for people with this form of heart failure," Shah said.
For spironolactone, Shah said more study is needed on whether the drug affects patients' potassium levels too much, which can cause an abnormal heart rhythm. In this study, patients on the drug had a "mild" increase in potassium, on average -- but they didn't have a higher risk of serious increases, and there were no hospitalizations for it.
The study was funded by government grants, but some researchers on the work have financial ties to Aldactone maker Pfizer, Inc.